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The Role of Clinical Pharmacist in Reducing Drug Related Problems in Hemodialysis Patients
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Abstract

Prescribing drugs to patients to treat ailments or reducing their morbidity may not be enough, even if the drugs were all indicated and in the right dose. Clinical pharmacists play a pivotal role in conducting information and instruction to patients and conveying feedback to treating physician when appropriate, and the final goal is in the interest of the patient.  Identification and classification of drug related problems and discussing them with the health care providers.  Prospective, interventional, clinical study for 180 hemodialysis patients, and was designed as two phases, an observational phase to identify drug related problems and classifying them according to the latest Pharmaceutical Care Network Europe classification, an interventional phase to increase the awareness of patients and the nephrologists about those problems and proposing a proper solution for each one.  The main drug related problems was related to the effect of drug treatment being not optimal in 58.7%, followed by no effect in 17.8%, and least for unrelated symptoms or indications in 4.8%; causes were inappropriate combination and patients taking less drug than prescribed (both 17.4%), followed by no/or incomplete drug treatment in spite of existing indication in 12.2%, drug without indication in 10.4%. Erythropoietin and calcium were the most frequently drugs with problems. Acceptance and full implementation were observed in 34.3%, while half of the drug related problems had unknown implementation (51.3%). There were significant numbers of drug related problems among Iraqi patients on hemodialysis, the use of erythropoietin, calcium carbonate and sevelamer  was responsible for most of inappropriate combinations. Physicians and clinical pharmacist cooperation was excellent.

Keywords: Drug related problems, Hemodialysis, Clinical pharmacist.

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
Effectiveness of Graduality, Escalation and Argumentation in Quranic Politeness Discourse “Surat Ghafir a Model” A Pragmatic Study
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Theauthor addressed politeness discourse in “Surat Ghafir”. Quran texts include many rhetorical utterances which are considered pragmatic mechanismsconcerned with finding polite discourse. examining these texts allow to determine the effectiveness degree in the discourse, and to find the effect level that leads to interaction between the speaker and the listener. Graduation is considered an effect and a mechanism of discourse escalation.
The author reached a common definition of the graduation effectiveness term, due to its importance in finding polite discourse that is constructed by lingual manifestations some of which are escalation and graduation. Escalation is a mechanism to show the level of discourse graduation, it is a mea

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Publication Date
Thu Oct 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Effect of 1,3-Oxazepine Derivative on Alkaline Phosphatase and Lactate Dehydrogenase Activity in Healthy Iraqi Females Serum
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Background: Heterocyclic compounds and its derivatives have biological activities and used as analgesic, anti-helminthic, antituberculer, antifungal, antiviral, anticancer and inhibitor of some enzymes. Oxazepine (benzodiazepine) derivative used in relief of psychoneuroses characterized by anxiety and tension. Alkaline phosphatase (ALP) hydrolyzes phosphate monoesters, while Lactate dehydrogenase (LDH) catalyses oxidation of L-lactate to pyruvate utilizing NAD+Objective: The study was carried out to know of the impact of 1,3-oxazepine derivative on the ALP and LDH enzyme activity on human serum in vitro.Methods: The study included the effect of synthesized 1,3-oxazepine divertive [(Z)-3-(5-mercapto-1-3,4-Thiadizol-2-yl)-2-(4-nitroph

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Publication Date
Wed Nov 28 2018
Journal Name
Al-khwarizmi Engineering Journal
Effect of Using Combined Square Nozzle & winglet with Helical Tape on Thermal Characteristics in Tube Heat Exchanger
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Influence of combined square nozzle with helical tape inserted in a constant heat flux tube on heat transfer enhancement for turbulent airflow for Reynolds number ranging from 7000 to 14500 were investigated experimentally. Three different pitch ratios for square nozzle (PR = 5.8, 7.7 and 11.6) according to three different numbers of square nozzle (N = 3, 4 and 5) and constant pitch ratios for helical tape were used. The results observed that the Nusselt number and friction factor for combination with winglets were found to be up to 33.8 % and 21.4 %, respectively higher than nozzle alone for pitch ratio PR=5.8. The maximum value of thermal performance for using combination with winglets was about 1.351 for pitch ratio= 5.8. Nusselt numb

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Publication Date
Wed Sep 30 2020
Journal Name
Iraqi Journal Of Chemical And Petroleum Engineering
Experimental Study for Assessment of Cutting Density Effect on Hole Cleaning Efficiency in Inclined and Horizontal Wells
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The poor hole cleaning efficiency could causes many problems such as high torque, drag, poor hydraulics and pipe stuck. These inherent problems result in an avoidable high operation cost which this study tried to address.  In this study, the effect of cutting density on hole cleaning efficiency in deviated and horizontal wells was investigated. Experiments were conducted using 40 feet (12 m) long of flow loop made from iron and PVC. However, the test section was made from PVC with (5.1m) long and (4” ID) for outer pipe and (2” OD) inner pipe. The cutting transport ratio (CTR) was determined from weight measurements for each test. Cutting Transport Ratio has been investigated for effects of the following parameters; flow rate, cu

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Publication Date
Wed Dec 15 2010
Journal Name
Iraqi Journal Of Laser
Photo Response of Locally Isolated Methicillin-Resistant Staphylococcus aureus to Q-switched Nd:YAG Laser In Vitro Study
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This prospective study investigates the prevalence of methicillin-resistant S.aureus (MRSA)
in burn unit of Al-Kindy Iraqi hospital, their susceptibility to antibiotics and bactericidal effect of near
infrared light from high powered 1064nm Nd: YAG laser and green light 532nm from SHG Nd: YAG laser
using various energy densities on these bacteria. Twenty four clinical isolates of S.aureus out of sixty
four examined patients with sever burn ulcers.MRSA was associated with 50% of S.aureus infections
.Results of antimicrobial susceptibility revealed that MRSA were multidrug resistant. After laser treatment
of non MRSA with Nd:YAG with wavelength of 1.064nm, 4mm beam diameter, energy density of
0.636 kh/cm2 and 180sec ex

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Publication Date
Mon May 27 2019
Journal Name
Al-khwarizmi Engineering Journal
Prediction of Process Parameters That Affecting on Surface Roughness in Multi-Point Forming Process Using ANOVA Algorithm
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Multipoint forming process is an engineering concept which means that the working surface of the punch and die is produced as hemispherical ends of individual active elements (called pins), where each pin can be independently, vertically displaced using a geometrically reconfigurable die. Several different products can be made without changing tools saved precious production time. Also, the manufacturing of very expensive rigid dies is reduced, and a lot of expenses are saved. But the most important aspects of using such types of equipment are the flexibility of the tooling. This paper presents an experimental investigation of the effect of three main parameters which are blank holder, rubber thickness and forming speed th

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Publication Date
Mon Apr 20 2020
Journal Name
Ibn Al-haitham Journal For Pure And Applied Science
Nutritional Value of White Button Mushroom (Agaricus bisporus) Which is Most Widely Consumed in kurdistan regin-iraq
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This study was conducted in 2018, at Technical College of Applied Sciences, Sulaimani Polytechnic University, and Kurdistan Region-Iraq. The aim of the study was to determinate nutritional compositions and some elemental contents in marketable white button mushroom (Agaricus bisporus) that is collected in local markets of Kurdistan Region-Iraq. Five different samples (A: Penjwen product fresh, B: Sulaimani product fresh, C: American caned, D: Valencia Netherlandcaned and E: Erbil product fresh) were collected to be observed. The elements were analyzed by Atomic Absorption Spectrometry methods, and their chemical compassions were determined, too. The collected data were analyzed by One Way ANOVA. The highest fat, protein, fiber and dry matte

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Publication Date
Thu Apr 18 2024
Journal Name
Eximia Journal
Forecasts some of functional indicators nervous system for dribbling skills in young basketball players from Baghdad Governorate
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The research study is important since it establishes predicted rates for various nervous system functional indicators.In terms of performing the skill of Dribbling in basketball for young players in Baghdad Governorate in order to reach scientific results that serve researchers, coaches, and players uniformly. The study's goal is to create predictive equations for specific functional indicators of the nervous system in relation to the Dribbling skill performance of young basketball players in Baghdad Governorate. The researchers used a descriptive approach with a survey method on (8) youth basketball league clubs in Baghdad Governorate for the 2022-2023 sports season, totaling (96) players . Three tests were used to measure the nervous sy

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Publication Date
Wed Nov 07 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of mothers' practices toward children with steroid – sensitive nephrotic syndrome at pediatrics hospitals in Baghdad city
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Objective(s): To assess mothers' practices toward children with steroid – sensitive Nephrotic Syndrome (SSNS) who
are visiting nephrology consultation units, and to find out the relationships between their practices and the
demographical data for mother and child.
Methodology: A descriptive study was carried out at nephrology consultation units of Baghdad pediatrics hospitals
(Child's Central Pediatric Teaching Hospital, Al-kadimiyia Teaching Hospital, and Welfare Teaching Hospital) started
from February 18th to the end of July 2009. A purposive sample of (80) mothers who company their children were
selected. The data were collected through a constructed questionnaire, with two parts; the first part is concerned with<

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Publication Date
Thu Jun 23 2022
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Flow Injection Spectrophotometric Technique for Determining of Genistein in Pure and Supplements Formulations Through Diazotization Coupling Reaction
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Genistein (GEN) is The major isoflavone found in soybeans, has a number of cardiovascular health benefits, Postmenopausal syndrome and osteoporosis. A direct flow injection analysis method for estimation of (GEN) in pure and supplements formulation . This system is based on diazotization coupling reactions between procaine penciline (PR) and genistein in basic medium, they formed yellow dyes have maximum absorption at 416 nm. Calibration curve were constructed over different GEN concentrations, linearity for GEN was 10-100 µg.mL-1 and detection limits of 1.51 ?g/mL. In the FIA technique, all analytical factors were analyzed and optimized. The established method was successfully used to determine GEN in the formulations of its supplement

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